JP2009112795A - 関節運動メカニズムを有する外科ステープラ - Google Patents
関節運動メカニズムを有する外科ステープラ Download PDFInfo
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/005—Flexible endoscopes
- A61B1/0051—Flexible endoscopes with controlled bending of insertion part
- A61B1/0052—Constructional details of control elements, e.g. handles
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
- A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07278—Stapler heads characterised by its sled or its staple holder
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2901—Details of shaft
- A61B2017/2905—Details of shaft flexible
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
- A61B2017/2912—Handles transmission of forces to actuating rod or piston
- A61B2017/2923—Toothed members, e.g. rack and pinion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B2017/320052—Guides for cutting instruments
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
- Y10T74/00—Machine element or mechanism
- Y10T74/12—Gyroscopes
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
- Y10T74/00—Machine element or mechanism
- Y10T74/18—Mechanical movements
- Y10T74/1836—Rotary to rotary
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
- Y10T74/00—Machine element or mechanism
- Y10T74/19—Gearing
Abstract
【解決手段】関節運動メカニズムは、細長い筐体と、該筐体内に少なくとも部分的に配置されたシャフトと、該シャフトと機械的に協働するように配置された第1の部材と、該シャフトと機械的に協働するように配置された第2の部材と、該第1の部材および該第2の部材と動作するように接続された可撓性部材であって、該可撓性部材は、遠位部分と近位部分とを有する、可撓性部材とを備えており、該シャフトの回転の際に、該第1の部材と該第2の部材との少なくとも一方が、該第1の部材と該第2の部材とが互いに対して近づけられた第1の位置と、該第1の部材と該第2の部材とが互いから間隔を空けられた第2の位置との間で、該第1の部材と該第2の部材との他方に対して長手方向に動き、該長手方向の運動が、該可撓性部材の該遠位部分を該近位部分に対して関節運動させる。
【選択図】図1
Description
本願は、2007年10月5日出願の米国仮特許出願第60/997,775号の優先権と利益とを主張し、該米国仮特許出願第60/997,775号の全内容が本明細書において参考として援用される。
本開示は、外科処置のための装置および方法に関する。さらに詳細には、本開示は、外科ステープラと、外科ステープラと共に使用するための関節運動メカニズムとに関する。
外科器具と共に使用する関節運動メカニズムであって、
細長い筐体と、
該筐体内に少なくとも部分的に配置されたシャフトと、
該シャフトと機械的に協働するように配置された第1の部材と、
該シャフトと機械的に協働するように配置された第2の部材と、
該第1の部材および該第2の部材と動作するように接続された可撓性部材であって、該可撓性部材は、遠位部分と近位部分とを有する、可撓性部材と
を備えており、
該シャフトの回転の際に、該第1の部材と該第2の部材との少なくとも一方が、該第1の部材と該第2の部材とが互いに対して近づけられた第1の位置と、該第1の部材と該第2の部材とが互いから間隔を空けられた第2の位置との間で、該第1の部材と該第2の部材との他方に対して長手方向に動き、該長手方向の運動が、該可撓性部材の該遠位部分を該近位部分に対して関節運動させる、メカニズム。
上記第1の部材と上記第2の部材とは、第1の方向への上記シャフトの回転の際に、上記第1の位置に動く、項目1に記載のメカニズム。
上記第1の部材と上記第2の部材とは、第2の方向への上記シャフトの回転の際に、上記第2の位置に動く、項目1に記載のメカニズム。
上記シャフトは、近位端と遠位端とを含み、ノブが、該近位端と該遠位端との少なくとも一方に固定されている、項目1に記載のメカニズム。
上記シャフトは、モータと動作するように結合されている、項目1に記載のメカニズム。
上記シャフトは、上記第1の部材と協働するように構成された左側の溝を含む、項目1に記載のメカニズム。
上記第1の部材は、上記シャフトの上記左側の溝を係合するように構成された第1のねじを含む、項目6に記載のメカニズム。
上記シャフトは、上記第2の部材と協働するように構成された右側の溝を含む、項目1に記載のメカニズム。
上記第2の部材は、上記シャフトの上記右側の溝を係合するように構成された第2のねじを含む、項目8に記載のメカニズム。
第1のケーブルと第2のケーブルとをさらに備え、該第1のケーブルは、上記第1の部材と上記可撓性部材の上記遠位部分とを相互接続し、該第2のケーブルは、上記第2の部材と該可撓性部材の該遠位部分とを相互接続する、項目1に記載のメカニズム。
上記筐体は、上記第1の部材と上記第2の部材との少なくとも一方の一部分を保持するように適合された長手方向スロットを含む、項目1に記載のメカニズム。
外科器具であって、
可撓性シャフトと、
該可撓性シャフトに動作するように接続された章動歯車駆動装置であって、該章動歯車駆動装置は、該可撓性シャフトの速度を低下させ、かつ、該可撓性シャフトのトルクを増加させるように構成されている、章動歯車駆動装置と、
該章動歯車駆動装置に選択的に取り付けられるように構成された駆動シャフトと
を備えている、外科器具。
作動スレッドをさらに備え、上記駆動シャフトは、該作動スレッドを選択的に動かすように適合されている、項目12に記載の外科器具。
ツールアセンブリをさらに備え、該ツールアセンブリは、アンビルとカートリッジとを含み、該アンビルは、該カートリッジに旋回するように接続されている、項目12に記載の外科器具。
上記駆動シャフトと動作するように結合されたクランプカムをさらに備え、該クランプカムは、該駆動シャフトの回転の際に移動し、それにより、上記カートリッジに対する上記アンビルの運動をもたらすように構成されている、項目14に記載の外科器具。
上記駆動シャフトに動作するように接続された第1の長い親ねじをさらに備え、該第1の長い親ねじは、該駆動シャフトの回転に応答して回転するように適合されており、上記作動スレッドが、少なくとも第1の長い親ねじの回転の際に移動する、項目13に記載の外科器具。
上記第1の長い親ねじを上記駆動シャフトに動作するように接続された第1のピニオン歯車をさらに備え、上記第1のピニオン歯車が、上記駆動シャフトの遠位端に固定されている、項目16に記載の外科器具。
上記クランプカムは、上記アンビルの近位部分を滑動可能に受け入れる傾斜面を含み、該傾斜面は、上記カートリッジに対する上記アンビルの運動を導くように適合されている、項目15に記載の外科器具。
上記駆動シャフトに動作するように接続された第2の長い親ねじをさらに備え、該第2の長い親ねじは、該駆動シャフトの回転に応答して回転するように適合されており、上記作動スレッドが、第1の長い親ねじおよび第2の長い親ねじの回転の際に移動する、項目17に記載の外科器具。
上記第1のピニオン歯車の回転の際に回転するように構成された、第2のピニオン歯車と第3のピニオン歯車とをさらに備え、該第2のピニオン歯車は、上記第1の長い親ねじの近位端に取り付けられ、該第3のピニオン歯車は、上記第2の長い親ねじの近位端に取り付けられている、項目19に記載の外科器具。
上記作動スレッドに形成された、第1のねじを切られたホールと、第2のねじを切られたホールとをさらに備え、該第1のねじを切られたホールは、上記第1の長い親ねじを受け入れるように構成され、該第2のねじを切られたホールは、上記第2の長い親ねじを受け入れるように構成されている、項目19に記載の外科器具。
外科器具と共に使用する関節運動メカニズムであって、
シャフトと、
該シャフトと機械的に協働するように配置された第1の部材と、
該シャフトと機械的に協働するように配置された第2の部材と、
該第1の部材および該第2の部材と動作するように接続された可撓性部材であって、該可撓性部材は、遠位部分と近位部分とを有する、可撓性部材と
を備えており、
該シャフトの回転の際に、該第1の部材と該第2の部材との少なくとも一方が、該第1の部材と該第2の部材とが互いに対して近づけられた第1の位置と、該第1の部材と該第2の部材とが互いから間隔を空けられた第2の位置との間で、該第1の部材と該第2の部材との他方に対して長手方向に動き、該長手方向の運動が、該可撓性部材の該遠位部分を該近位部分に対して関節運動させる、メカニズム。
「J」(図27を参照)で示されるように、反時計回り方向に、第2のピニオン歯車195および第3のピニオン歯車196の回転をもたらす。第2のピニオン歯車195および第3のピニオン歯車196が回転している間に、第1の長い親ねじ139および第2の長い親ねじ137が、回転し、それにより、矢印「K」(図25を参照)で示されるように、カートリッジ107を通って遠位方向に作動スレッド135を前進させる。遠位方向に動いている間に、作動スレッド135は、プッシャ131と連続して接触する。次に、プッシャ131は、保持スロット105の中で垂直に移動し、そして、ファスナ125を排出する。プッシャ131が、アンビル192に向かってファスナを駆動させたときに、ファスナ変形凹部113が、ファスナ125の脚を変形させる。その後、ユーザは、反時計回り方向に可撓性シャフト122を回転させることによって作動スレッド135を近位方向に動かす選択肢を有する。
外科器具と共に使用する関節運動メカニズムは、シャフトと、関節運動シャフトと機械的に協働するように配置された第1の部材と、シャフトと機械的に協働するように配置された第2の部材と、近位部分および遠位部分を有する可撓性シャフトとを含む。可撓性部材は、第1の部材と第2の部材とに動作するように接続されている。関節運動シャフトの回転の際に、第1の部材と第2の部材との少なくとも一方が、第1の部材と第2の部材とが互いに対して近づけられた第1の位置と、第1の部材と第2の部材とが互いから間隔を空けられた第2の位置との間で、第1の部材と第2の部材との他方に対して長手方向に動く。この長手方向の運動が、可撓性部材の遠位部分を近位部分に対して関節運動させる。
Claims (22)
- 外科器具と共に使用する関節運動メカニズムであって、
細長い筐体と、
該筐体内に少なくとも部分的に配置されたシャフトと、
該シャフトと機械的に協働するように配置された第1の部材と、
該シャフトと機械的に協働するように配置された第2の部材と、
該第1の部材および該第2の部材と動作するように接続された可撓性部材であって、該可撓性部材は、遠位部分と近位部分とを有する、可撓性部材と
を備えており、
該シャフトの回転の際に、該第1の部材と該第2の部材との少なくとも一方が、該第1の部材と該第2の部材とが互いに対して近づけられた第1の位置と、該第1の部材と該第2の部材とが互いから間隔を空けられた第2の位置との間で、該第1の部材と該第2の部材との他方に対して長手方向に動き、該長手方向の運動が、該可撓性部材の該遠位部分を該近位部分に対して関節運動させる、メカニズム。 - 前記第1の部材と前記第2の部材とは、第1の方向への前記シャフトの回転の際に、前記第1の位置に動く、請求項1に記載のメカニズム。
- 前記第1の部材と前記第2の部材とは、第2の方向への前記シャフトの回転の際に、前記第2の位置に動く、請求項1に記載のメカニズム。
- 前記シャフトは、近位端と遠位端とを含み、ノブが、該近位端と該遠位端との少なくとも一方に固定されている、請求項1に記載のメカニズム。
- 前記シャフトは、モータと動作するように結合されている、請求項1に記載のメカニズム。
- 前記シャフトは、前記第1の部材と協働するように構成された左側の溝を含む、請求項1に記載のメカニズム。
- 前記第1の部材は、前記シャフトの前記左側の溝を係合するように構成された第1のねじを含む、請求項6に記載のメカニズム。
- 前記シャフトは、前記第2の部材と協働するように構成された右側の溝を含む、請求項1に記載のメカニズム。
- 前記第2の部材は、前記シャフトの前記右側の溝を係合するように構成された第2のねじを含む、請求項8に記載のメカニズム。
- 第1のケーブルと第2のケーブルとをさらに備え、該第1のケーブルは、前記第1の部材と前記可撓性部材の前記遠位部分とを相互接続し、該第2のケーブルは、前記第2の部材と該可撓性部材の該遠位部分とを相互接続する、請求項1に記載のメカニズム。
- 前記筐体は、前記第1の部材と前記第2の部材との少なくとも一方の一部分を保持するように適合された長手方向スロットを含む、請求項1に記載のメカニズム。
- 外科器具であって、
可撓性シャフトと、
該可撓性シャフトに動作するように接続された章動歯車駆動装置であって、該章動歯車駆動装置は、該可撓性シャフトの速度を低下させ、かつ、該可撓性シャフトのトルクを増加させるように構成されている、章動歯車駆動装置と、
該章動歯車駆動装置に選択的に取り付けられるように構成された駆動シャフトと
を備えている、外科器具。 - 作動スレッドをさらに備え、前記駆動シャフトは、該作動スレッドを選択的に動かすように適合されている、請求項12に記載の外科器具。
- ツールアセンブリをさらに備え、該ツールアセンブリは、アンビルとカートリッジとを含み、該アンビルは、該カートリッジに旋回するように接続されている、請求項12に記載の外科器具。
- 前記駆動シャフトと動作するように結合されたクランプカムをさらに備え、該クランプカムは、該駆動シャフトの回転の際に移動し、それにより、前記カートリッジに対する前記アンビルの運動をもたらすように構成されている、請求項14に記載の外科器具。
- 前記駆動シャフトに動作するように接続された第1の長い親ねじをさらに備え、該第1の長い親ねじは、該駆動シャフトの回転に応答して回転するように適合されており、前記作動スレッドが、少なくとも第1の長い親ねじの回転の際に移動する、請求項13に記載の外科器具。
- 前記第1の長い親ねじを前記駆動シャフトに動作するように接続された第1のピニオン歯車をさらに備え、前記第1のピニオン歯車が、前記駆動シャフトの遠位端に固定されている、請求項16に記載の外科器具。
- 前記クランプカムは、前記アンビルの近位部分を滑動可能に受け入れる傾斜面を含み、該傾斜面は、前記カートリッジに対する前記アンビルの運動を導くように適合されている、請求項15に記載の外科器具。
- 前記駆動シャフトに動作するように接続された第2の長い親ねじをさらに備え、該第2の長い親ねじは、該駆動シャフトの回転に応答して回転するように適合されており、前記作動スレッドが、第1の長い親ねじおよび第2の長い親ねじの回転の際に移動する、請求項17に記載の外科器具。
- 前記第1のピニオン歯車の回転の際に回転するように構成された、第2のピニオン歯車と第3のピニオン歯車とをさらに備え、該第2のピニオン歯車は、前記第1の長い親ねじの近位端に取り付けられ、該第3のピニオン歯車は、前記第2の長い親ねじの近位端に取り付けられている、請求項19に記載の外科器具。
- 前記作動スレッドに形成された、第1のねじを切られたホールと、第2のねじを切られたホールとをさらに備え、該第1のねじを切られたホールは、前記第1の長い親ねじを受け入れるように構成され、該第2のねじを切られたホールは、前記第2の長い親ねじを受け入れるように構成されている、請求項19に記載の外科器具。
- 外科器具と共に使用する関節運動メカニズムであって、
シャフトと、
該シャフトと機械的に協働するように配置された第1の部材と、
該シャフトと機械的に協働するように配置された第2の部材と、
該第1の部材および該第2の部材と動作するように接続された可撓性部材であって、該可撓性部材は、遠位部分と近位部分とを有する、可撓性部材と
を備えており、
該シャフトの回転の際に、該第1の部材と該第2の部材との少なくとも一方が、該第1の部材と該第2の部材とが互いに対して近づけられた第1の位置と、該第1の部材と該第2の部材とが互いから間隔を空けられた第2の位置との間で、該第1の部材と該第2の部材との他方に対して長手方向に動き、該長手方向の運動が、該可撓性部材の該遠位部分を該近位部分に対して関節運動させる、メカニズム。
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US20140131421A1 (en) | 2014-05-15 |
US8950646B2 (en) | 2015-02-10 |
CN102920491B (zh) | 2015-01-14 |
CN101401737A (zh) | 2009-04-08 |
EP2044888A2 (en) | 2009-04-08 |
CA2640345A1 (en) | 2009-04-05 |
US20090090764A1 (en) | 2009-04-09 |
US8292147B2 (en) | 2012-10-23 |
US8631988B2 (en) | 2014-01-21 |
CA2640345C (en) | 2017-11-07 |
EP2044888B1 (en) | 2016-12-07 |
AU2008229795B2 (en) | 2014-02-13 |
EP2044888A3 (en) | 2009-07-22 |
JP5403783B2 (ja) | 2014-01-29 |
US20130032627A1 (en) | 2013-02-07 |
CN102920491A (zh) | 2013-02-13 |
CN101401737B (zh) | 2012-11-14 |
AU2008229795A1 (en) | 2009-04-23 |
US20110163149A1 (en) | 2011-07-07 |
EP2428166A1 (en) | 2012-03-14 |
US7909220B2 (en) | 2011-03-22 |
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